Injury
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Multicenter Study
Outcome and complications of posterior transiliac plating for vertically unstable sacral fractures.
Vertically unstable sacral fractures often make it difficult to achieve rigid fixation and there is no consensus on the optimal fixation technique for these injuries. The purpose of this study was to evaluate complication rate and short-term outcome of vertically unstable sacral fractures treated by posterior transiliac plate fixation. We performed a retrospective review of prospectively collected data of patients who underwent posterior transiliac plating for sacral fractures at two institutions. ⋯ A total of 18 patients completed the functional assessment with a mean score of 78.5 points. Posterior plate fixation of vertically unstable sacral fractures is effective in maintaining fracture reduction even in the presence of significant posterior comminution. We caution its use in the presence of a known Morel-Lavallee lesion, as this may increase the wound complication and infection risk.
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The 8.0 magnitude earthquake that struck China on May 12, 2008, was the deadliest earthquake in 30 years. Most hospitals were destroyed and limited facilities were available for medical service in the earthquake regions. Over the first 5 days, three general hospitals and one children's hospital admitted 1770 injured individuals. ⋯ We gathered information from resources in Chinese, which at the time contained more records on this event than any documents in English. The age of the patients ranged from 7 days to 84 years old. Subjects over age 75 and children between 10 and 14 were the largest population in their respective hospitals, indicating that these groups required the greatest medical resources. The injury profile presented here serves as a reference not only for present injury intervention but also for future earthquake disaster response.
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Multicenter Study
Pancreatic injury in damage control laparotomies: Is pancreatic resection safe during the initial laparotomy?
While damage control (DC) techniques such as the rapid control of exsanguinating haemorrhage and gastrointestinal contamination have improved survival in severely injured patients, the optimal pancreatic injury management strategy in these critically injured patients requiring DC is uncertain. We sought to characterise pancreatic injury patterns and outcomes to better determine optimal initial operative management in the DC population. ⋯ The presence of shock or major vascular injury dictates the extent of pancreatic operative intervention. While pancreatic resection may be required in selected damage control patients, packing with pancreatic drainage effectively controls both haemorrhage and abdominal contamination in patients with life-threatening physiological parameters and may lead to improved survival. Increased mortality rates in patients who were packed without drainage suggest that packing without drainage is ineffective and should be abandoned.
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Randomized Controlled Trial Multicenter Study
Low-intensity pulsed ultrasound (LIPUS) in fresh clavicle fractures: a multi-centre double blind randomised controlled trial.
Several randomised trials have been published on the effect of low-intensity pulsed ultrasound (LIPUS) on fracture healing in both distal radius and tibia fractures. Most studies showed a positive effect on time to clinical and radiological healing. We hypothesised that LIPUS has a beneficial effect on the healing of fresh clavicle fractures as well and studied its effect in non-operatively treated shaft fractures. ⋯ Level 1 evidence that low-intensity pulsed ultrasound does not accelerate clinical fracture healing in non-operatively treated fresh midshaft clavicle fractures.
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Multicenter Study
Epidemiology and outcome after hip fracture in the under 65s-evidence from the Scottish Hip Fracture Audit.
To report the epidemiology and outcomes after hip fractures in the patients under 65 years of age. ⋯ Patients aged 50-64 years have significantly better outcome measures after surgery for hip fracture in terms of survival and function. Such differences exist even after controlling for differences in patient case-mix variables.